Diagnosis and treatment of diabetes and high blood pressure are key to the well-being of refugees and asylum seekers. Moreover, the social determinants of health, such as poverty and education, contribute to the development of these chronic diseases. Considering these factors, it is important to develop a comprehensive program for prevention, treatment and rehabilitation.
Diagnosis
Diagnosis of diabetes and high blood-pressure in refugees is a major public health challenge. The new-arrival screening for adults is a good opportunity to learn more about refugees’ lifestyles and discuss their diet, exercise, and physical activity. According to the CDC, screening for cardiovascular disorders should be included in routine health visits.
The study’s authors examined the prevalence of diabetes and hypertension among long-displaced Syrian refugees in northern Jordan and looked at the level of access to care. They found that biologically based rates of both disorders were higher than self-reported rates. However, the prevalence of diabetes and hypertension among Syrian refugees was lower than in Turkey. Furthermore, only 49 percent of participants sought medical attention in the past month. Approximately 26 percent missed their medications in the previous week, which is an indicator of high blood pressure.
A multidisciplinary care model was used to address these health disparities. Patients were assigned a care manager who coordinated care and services for the patients. The care manager also connected the patients with a culturally appropriate navigator. As a result, the I-Care program was able to improve health outcomes for this diverse population.
Treatment
Immigrants and refugees experience many barriers to health care and are more likely to suffer from poorly controlled chronic diseases, such as diabetes. Among these obstacles are inadequate health literacy, alternative paradigms about health and illness, and complex community dynamics. By incorporating cultural and social context into the treatment process, refugees and immigrants can receive high-quality diabetes care.
The clinic provides care to a large group of refugees in Uganda’s Nakivale refugee settlement, which is home to both Ugandan nationals and refugees. The prevalence of diabetes among refugees was 2.3% (95% CI: 1.4%-3.7), while the prevalence of hypertension was lower than the national average of 26.5%. While the study showed relatively low prevalence rates, it is still important to incorporate a comprehensive screening program for refugees who are at high risk for both conditions.
Outcomes
The prevalence of diabetes and hypertension among refugees is higher than the general population. However, the study has limitations. For example, the study excluded individuals who did not have either type of diabetes or hypertension. Also, it did not include children under the age of five and adults who were not capable of participating independently. As a result, the results may not be applicable to all patients without medical care. Also, the results may not be applicable to patients who lived in different health facilities or in different geographic areas.
The study also found that most refugees attribute their illnesses to non-material causes. Hmong people attribute diabetes to “loss of balance” and “sadness.” Vietnamese people attribute high blood pressure to “perspiration less” and “excessive worrying.” In addition, many refugees use traditional remedies in addition to Western medicine. According to one study, 73% of Cambodian refugees had used traditional treatment within the last year.
Social determinants of health
A study in Sweden found that refugees in deprived neighborhoods are more likely to develop diabetes. This disease is caused by a lack of insulin. It is also linked to obesity and stress. Ultimately, the disease will be the seventh leading cause of death by 2030.
The study found that SES and being homeless during childhood were associated with higher systolic blood pressure among immigrants. Thus, addressing the social determinants of health is important to improve health outcomes in this population. In particular, studies involving refugee populations must examine the impact of immigration on blood pressure.
In addition to poverty, poor housing conditions and low nutritional quality of food could all contribute to increased risk of these diseases. In addition, refugee communities may suffer from greater psychological stress and less physical activity. Researchers must consider these factors when assigning refugees to specific neighborhoods.
Interventions
During new-arrival screening, healthcare providers can discuss the importance of diet and exercise for cardiovascular health with new arrivals. In addition, new arrivals can be counseled on the importance of preventive health visits. The CDC recommends screening for cardiovascular disorders and diabetes.
Programs targeting hypertension and diabetes should consider the sociodemographic characteristics of the participants. Immigrant populations may experience greater difficulty in engaging in healthcare. Identifying immigrant populations that need targeted interventions is essential for designing interventions that meet their unique needs. For example, a treatment aimed at reducing hypertension should be gender-based. Similarly, interventions should be designed so that they are affordable for immigrants, because they face high out-of-pocket costs.
Community-based participatory research, which involves community members, is an important approach for interventions targeting immigrants. It involves working with community-based organizations and community leaders to design and implement interventions. Using the CFIR framework, researchers are able to evaluate the effectiveness of interventions and evaluate the need for innovation across different stages of the intervention process. The framework also allows investigators to examine the characteristics of intervention participants and the characteristics of their inner environments.
